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Objective: To systematically assess literature examining the impact of being a gamer or participating in video-game-based training on surgical skills acquisition amongst medical students.

Background: Video games and surgical procedures share similar skills such as visuospatial abilities and hand-eye coordination; therefore, video games can be a valuable tool for surgical training amongst medical students. However, comprehensive, up-to-date systematic reviews are necessary to confirm.

Methods: A systematic literature search of PubMed, MEDLINE, and EMBASE was performed in April 2020 with no limits set on the date of publication. Observational and randomized controlled studies were included. Quality and bias were assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Grading of Recommendations Assessment, Development and Evaluation system for randomized studies.

Results: A total of 575 participants from 16 studies were included. The most common surgical skills tested were laparoscopy (n = 283, from 8 studies) and robotic surgery (n = 199, from 5 studies). A history of gaming and video-game-based training were associated with improved metrics in robotic surgery and laparoscopy, respectively. Neither was beneficial in arthroscopy or bronchoscopy. Studies using the Wii U and Underground reported significant improvement in overall laparoscopic performance.

Conclusion: Video games demonstrate potential as adjunctive training in surgical skill education, with a history of gaming and video-game-based training being beneficial in robotic surgery and laparoscopy, respectively. Methodological heterogeneity amongst included studies limit the ability to make conclusive decisions; thus, future studies with long-term follow-up, larger sample sizes, outcomes stratified by video-game characteristics, and up-to-date technology are necessary.

Read more on Can video games enhance surgical skills acquisition for medical students? A systematic review via Surgery.

“Background and Study Aim. Attention and concentration, fundamental psychological skills, are crucial in situations where the opponent moves rapidly and incessantly. Reaction time is also of paramount importance in winning a game in fencing, which requires both offensive and defensive actions. Understanding the factors that affect reaction time is essential for improving performance. This study aimed to investigate the impact of disruptions in attention and concentration on reaction time in fencing.

Material and Methods. Thirty-four healthy male and female fencers participated in two testing sessions. In the initial session, participants filled out a personal information form and took the d2 Attention Test to determine their attention levels. They also completed items representing the concentration disruption subscale of the Sport Anxiety Scale-2 (SAS-2) to measure concentration levels. In the second session, participants underwent the Favero Electronic Fencing Target (EFT-1) test to measure their reaction times. To analyze the obtained data, SPSS 20 was used. The Pearson correlation coefficient between attention, concentration disruption, and participants’ reaction times was calculated. Then, linear regression analysis was employed to test whether attention and concentration scores could predict the reaction times.

Results. The findings indicated that there is a significant positive relationship between E (r = .603, p < .01), E% (r = .628, p < .01), E1 (r = .584, p < .01), E2 (r = .533, p < .01), and reaction time. Additionally, a significant negative relationship was revealed between concentration performance and reaction times (r = -.456, p < .01). A significant positive correlation was observed between fencers’ concentration disruption and reaction times (r = .416, p < .05).

Conclusions. Our study results emphasize the importance of attention and concentration in disciplines that require quick reactions. These cognitive factors need to be considered in the development of sports performance.”

Read more on the Examining the effects of attention and concentration levels on reaction time in fencing via Physical Education of Students.

“Generative artificial intelligence (AI) models are increasingly utilized for medical applications. We tested whether such models are prone to human-like cognitive biases when offering medical recommendations. We explored the performance of OpenAI generative pretrained transformer (GPT)-4 and Google Gemini-1.0-Pro with clinical cases that involved 10 cognitive biases and system prompts that created synthetic clinician respondents.

Medical recommendations from generative AI were compared with strict axioms of rationality and prior results from clinicians. We found that significant discrepancies were apparent for most biases. For example, surgery was recommended more frequently for lung cancer when framed in survival rather than mortality statistics (framing effect: 75% vs. 12%; P<0.001). Similarly, pulmonary embolism was more likely to be listed in the differential diagnoses if the opening sentence mentioned hemoptysis rather than chronic obstructive pulmonary disease (primacy effect: 100% vs. 26%; P<0.001). In addition, the same emergency department treatment was more likely to be rated as inappropriate if the patient subsequently died rather than recovered (hindsight bias: 85% vs. 0%; P<0.001). One exception was base-rate neglect that showed no bias when interpreting a positive viral screening test (correction for false positives: 94% vs. 93%; P=0.431).

The extent of these biases varied minimally with the characteristics of synthetic respondents, was generally larger than observed in prior research with practicing clinicians, and differed between generative AI models. We suggest that generative AI models display human-like cognitive biases and that the magnitude of bias can be larger than observed in practicing clinicians.”

More on Cognitive Biases & Artificial Intelligence via NEJM AI.

“The state of childhood in Canada has reached a breaking point. The seventh annual Raising Canada report, released today, finds that the top 10 threats to childhood are escalating, with children’s quality of life in Canada demonstrably worsening. The report includes an urgent call for policymakers to address and overcome these pressing issues. It also calls on community leaders to recognize the value of youth engagement as a critical element of creating and implementing solutions to complex social issues.

The annual Raising Canada report is published by Children First Canada, based on research conducted by the University of Calgary and McGill University. Researchers compiled existing data and conducted interviews with youth, parents and other subject matter experts. It comes as Canada ranks 66th out of 194 countries on the global Kids Rights Index.

Among the startling findings:

• 28.4% of children under 18 live in food-insecure households, an increase from 24.3% the previous year.
• One in five kids (20%) in Canada have diagnosed mental health challenges.
• Two-thirds (60%) of Canadians reported experiencing maltreatment (including physical and/or emotional abuse) before the age of 15.
• Police reports of online sexual exploitation of children have nearly tripled since 2014; Sextortion reports have increased by 150% since June 2022 and online sexual luring reports have surged 815% over the last five years.
• Hospital stays for children under four have increased by 32% due to respiratory illnesses.
• Child homicide and filicide are significant threats to children’s survival, with 40 child homicides reported in 2022.

This year’s report also highlights several cross-cutting themes, including the influence of technology on children and adolescents. Researchers note that digital platforms have made it easier to create and share messages of hate, discrimination, and cyberbullying, which adversely impact mental health, physical activity, and the risk of violence and abuse. Evidence also concludes that the negative effects of technology on mental health have intensified since the onset of the pandemic, with the RCMP warning that victims face extreme outcomes of sextortion, including self-harm or suicide.

“Children today are facing unprecedented threats—from rising poverty and mental health crises to violence in their homes and online. Parents are struggling to offer their children a better way of life than they had,” says Sara Austin, Founder and CEO of Children First Canada. “Canada’s kids deserve better—a better childhood and a brighter future, and their survival and ability to thrive depend on the choices we make today. We must act with urgency and conviction to turn this around.”

Read more on New Report Reveals Record Increases in Violence, Poverty, Mental Health Issues and Sexploitation Among Canada’s Kids (2024) via Children First Canada.

Causation vs. Correlation: The Coffee and Baby Sleep Saga

Imagine you’re on your 24-hour call shift and you notice a strange trend: the nights you chug coffee after dinner, the clinic’s tiniest patients—babies—seem to cry more. Hmm, you think, “Does my coffee cause baby insomnia?”

Before you start banning coffee on call, let’s unpack two key concepts:

1️⃣ Correlation: This is when two things happen together. In this case, your coffee habit and baby tears seem to rise in tandem. Coincidence? Maybe. Correlation is like spotting two family members wearing plaid shirts at the same time—they’re connected somehow, but you can’t be sure it’s because they planned it.

2️⃣ Causation: This is when one thing directly causes another. If your coffee somehow made its way into those babies’ milk bottles, then you’d have causation.

Here’s the twist: just because two things are correlated doesn’t mean one causes the other. Maybe babies are just naturally fussier on stormy nights, and you drink coffee to power through those wild weather calls. The real culprit could be thunderclouds, not caffeine.

Key Takeaway: Don’t jump to conclusions! Always dig deeper, just like when a patient’s mysterious rash pops up. Is it an allergy (causation) or coincidence?

Background: In Canada, many patients face substantial out-of-pocket costs for prescription medication, which may affect their ability to take their medications as prescribed. We sought to conduct a comprehensive analysis of the burden and predictors of cost-related nonadherence in Canada.

Methods: Using pooled data from the 2015, 2016, 2018, 2019, and 2020 iterations of the Canadian Community Health Survey, we calculated weighted population estimates of the burden of cost-related nonadherence in the preceding 12 months and used logistic regression models to measure the association of 15 demographic, health, and health system predictors of cost-related nonadherence overall and stratified by sex.

Results: We included 223 085 respondents. We found that 4.9% of respondents aged 12 years or older reported cost-related nonadherence. Those who self-identified as female, belonging to a racial or ethnic minority group, or bisexual, pansexual, or questioning were more likely to report cost-related nonadherence. Younger age, higher disease burden, poorer health, non-employer prescription drug coverage, and not living in the province of Quebec were associated with cost-related nonadherence.

Interpretation: Our nationally representative findings reveal inequities that disproportionally affect marginalized people at the intersections of sex, race, age, and disability, and vary by province. This foundational understanding of the state of cost-related nonadherence may be used to inform potential expansion of public drug coverage eligibility, premiums, and cost-sharing policies that address financial barriers to medication adherence.

Predictors of cost-related medication nonadherence in Canada: a repeated cross-sectional analysis of the Canadian Community Health Survey via CMAJ.

“As artificial intelligence continues to develop in seemingly all facets of life — including health care — experts say it’s important for patients to know AI may be used in their care.

‘I think we’re going to see significant advances in AI use and AI capacity in the next few years,’ said Dr. Sian Tsuei, a family physician at Metrotown Urgent and Primary Care Centre in Burnaby, B.C.

‘I think we’re only seeing the start of it. So I would really encourage patients to continuously stay informed and for doctors to also be staying informed.’

Here are some AI risks and benefits Tsuei and other experts recommend you discuss with your health-care provider…

Read more on What patients should know about doctor visit summaries by AI via CBC.

Early blood glucose control for people with type 2 diabetes is crucial for reducing complications and prolonging life

“These latest results from the UK Prospective Diabetes Study (UKPDS), one of the longest ever clinical trials in type 2 diabetes, were made feasible by incorporating NHS data.

Professor Rury Holman of Oxford’s Radcliffe Department of Medicine, the founding Director of the University of Oxford Diabetes Trials Unit and Chief Investigator of the UKPDS, said, ‘These remarkable findings emphasise the critical importance of detecting and treating type 2 diabetes intensively at the earliest possible opportunity.

‘People may have type 2 diabetes for several years before being diagnosed as they may have few symptoms until their blood sugars become substantially elevated.’”

Learn more via University of Oxford.